Flap and incision design in implant surgery: clinical and anatomical study.
OBJECTIVE
The protection of microcircular support which is essential for healing gains importance if implant surgery is considered to affect the blood flow. The aim of the study is to establish the artery territories supplying the blood into the oral mucosa in the cadavers and to demonstrate the mucosal delivery pattern and to evaluate the effects of different incision types on the healing in the patients having the implant application.


METHODS
The study was planned in two stages as cadaver and clinical investigations. In cadaver investigation, all intra oral vascular territories were shown in ten specimens. The arterial structure and mucosal vascularity of the area were assessed microscopically and macroscopically. With the obtained data, the clinic results were established by making the crestal incision only for Group 1 (n = 30); both crestal and vertical releasing incisions for Group 2 (n = 30) were planned.


RESULTS
The results were established anatomically and clinically. In all cases, vascular territories of the mucosa in the maxilla and mandible were evaluated. In stereo microscopic assessment, although vestibule and oral mucosa had rich anastomoses, the crestal line had avascular features. There was no complication in the soft tissues of the cases, performed the vertical releasing incision during the healing period after 8-week follow-up.


CONCLUSIONS
The vascular richness of the oral mucosal area enables the sufficient healing in the areas of applied flap. According to the alveolar anatomical pattern and the amount of the soft tissue over it, the incisions may be applied horizontally and/or vertically.
Koymen
Ramazan
R
Department of Oral and Maxillofacial Surgery, Gulhane Medical School, Ankara, Turkey.
Karacayli
Umit
U
Gocmen-Mas
Nuket
N
Ertugrul-Koymen
Cevlan
C
Ortakoglu
Kerim
K
Gunaydin
Yilmaz
Y
Magden
Orhan
O
D000328:Adult; D000368:Aged; D002102:Cadaver; D015921:Dental Implants; D006801:Humans; D008297:Male; D008334:Mandible; D008437:Maxilla; D008875:Middle Aged; D009061:Mouth Mucosa / Q000098:blood supply* / Q000601:surgery*; D013524:Surgical Flaps; D014945:Wound Healing / Q000502:physiology
D015921:Dental Implants